Telehealth boom is building a 'drive-thru' healthcare system — but at what cost?
The rapid growth of telehealth and urgent care since COVID-19 has created a 'drive-thru' healthcare model that prioritizes convenience and profit over comprehensive, continuous care, risking fragmented treatment and overuse of profitable services like weight loss and hair loss drugs—even as these services expand access for millions. The American Hospital Association projects a shortage of up to 86,000 physicians by 2036, deepening the crisis of lost primary care infrastructure.
The Vox article describes how Americans have become accustomed to 'drive-thru' healthcare—telehealth visits for common complaints, prescriptions for hair loss and weight loss delivered by mail, and urgent care for everything else. Since the pandemic, telehealth use has exploded: the U.S. telehealth market was valued at $46.1 billion in 2024 and is projected to reach $83.63 billion by 2030, with nearly triple the pre-pandemic physician adoption rates. This model, championed by startups like Hims & Hers and Ro, treats healthcare as a retail transaction: fast, convenient, and narrowly focused on the symptom du jour.
The problem is not convenience itself but what it displaces. The 'drive-thru' model financially incentivizes episodic, disease-management visits rather than preventive, whole-person primary care. A patient ordering hair loss medication via a 15-minute online questionnaire never gets their blood pressure checked or cancer screened. Meanwhile, the American Hospital Association warns of a shortage of up to 86,000 physicians by 2036, making the erosion of primary care's comprehensive role even more dangerous. For patients without a medical home, the drive-thru becomes a trap: easy access to pills, no access to a doctor who knows their history.
The humanitarian alternative
Rather than banning or hampering telehealth, policymakers should tie its reimbursement to value-based care models that reward continuity and prevention. Medicare and state Medicaid programs can require that telehealth providers offer, or connect patients to, a primary care medical home, with shared savings for keeping patients healthy. Licensing reciprocity for telehealth across states should be paired with federal quality measures that track whether tele-visits include preventive screenings or follow-up on chronic conditions. A public telehealth option—administered by CMS—could set a standard for comprehensive virtual care, ensuring that convenient access doesn't become an excuse for fragmented, low-quality medicine.
Falsifiable predictions
What this entry claims will happen, and what data would prove it wrong. The Reckoner revisits these against current reality.
- By 2028, at least 5 major insurers will require telehealth platforms to demonstrate adherence to continuity-of-care metrics, such as annual preventive visits, before reimbursing for common chronic condition prescriptions.
Grounded in
- The Netherlands has universal health insurance — and it's all private
- Health Care | Vox
- Fact Sheet: Telehealth | AHA - American Hospital Association
- The State of Telehealth Before and After the COVID-19 Pandemic
- New data details how telehealth use varies by physician specialty
- US Telehealth & Telemedicine Market Report 2025-2030, By ...
- Telehealth Market Size, Share, Trends | Industry Report 2030
Original source — excerpted
news How Americans got hooked on “drive-thru” healthcare"covers health for Vox, guiding readers through the emerging opportunities and challenges in improving our health. He has reported on health policy for more than..."